Journal article
Is routine use of the intensive care unit after elective infrarenal abdominal aortic aneurysm repair necessary?
Journal of vascular surgery, v 32(4), pp 634-642
01 Oct 2000
PMID: 11013024
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Introduction: Postoperative care after infrarenal abdominal aortic aneurysm (AAA) repair has traditionally involved admission to the intensive care unit (ICU). With the advent of endovascular AAA repair, the management of open procedures has received increased scrutiny. We recently modified our AAA clinical pathway to include selective use of the ICU. Methods: Consecutive elective infrarenal AAA repairs performed by members of the vascular surgery division at a university medical center from 1994 to 1999 were analyzed retrospectively with a computerized database, the Medical Archival Retrieval System. Group I consisted of 245 patients who were treated in the ICU for 1 or more days, and Group II included 69 patients admitted directly to the floor. Ruptured, symptomatic, suprarenal, endovascular, and reoperative repairs were excluded. Outcome variables were compared over the 6-year period. Results: Floor admissions increased over the study period with 0%, 0%, 3.3%, 16.3%, 48.6%, and 43.6% of patients admitted directly to the surgery ward from 1994 to 1999. The average ICU length of stay declined from 4.6 to 1.2 days, whereas the hospital length of stay decreased from 12.5 to 6.8 days from 1994 to 1999. The change in ICU use had no effect on death (2.4% in Group I vs 0% in Group II). Major and minor morbidity was comparable. Hospital charges were significantly lower for patients in Group II. Conclusion: A policy of selective utilization of the ICU after elective infrarenal AAA repair is safe. It can reduce resource use without a negative impact on the quality of care. (J Vasc Surg 2000;32:634-42.)
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Details
- Title
- Is routine use of the intensive care unit after elective infrarenal abdominal aortic aneurysm repair necessary?
- Creators
- Daniel J. Bertges - University of Pittsburgh Medical CenterRobert Y. Rhee - University of Pittsburgh Medical CenterSatish C. Muluk - University of Pittsburgh Medical CenterJeffery D. Trachtenberg - University of Pittsburgh Medical CenterDavid L. Steed - University of Pittsburgh Medical CenterMarshall W. Webster - University of Pittsburgh Medical CenterMichel S. Makaroun - University of Pittsburgh Medical Center
- Publication Details
- Journal of vascular surgery, v 32(4), pp 634-642
- Publisher
- Mosby, Inc
- Number of pages
- 9
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Cardiothoracic Surgery
- Web of Science ID
- WOS:000089919600002
- Scopus ID
- 2-s2.0-0033789538
- Other Identifier
- 991021944486004721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Peripheral Vascular Disease
- Surgery